Having a family member tag along to your doctor’s visit or be with you during an emergency situation brings a sense of comfort for all patients. But for those who are not fluent in English or cannot speak the language, having a family member who is English-proficient may seem to be an added bonus.
However, having family members serve as an interpreter between the patient and health care professionals is risky because it is impossible to know if the message is being interpreted correctly. Having a family member interpret also eliminates the patient’s voice and understanding of their own medical diagnosis or treatment. From a legal standpoint, our responsibility for the provision of effective communication in accordance with Joint Commission, CLAS Standards, Title VI of Civil Rights Act of 1964, American Disabilities Act of 1990 and Section 1557 of Affordable Care Act, could result in having a family member interpret medical information to a patient become a liability to our health care system. UofL Health Language Services policy indicates that family members are not to be used for interpretation unless it is an urgent situation until a qualified resource is made available in order to protect our patients, providers and health care system.
Staff and providers may think it is convenient for a patient’s visitor to interpret as they seemingly speak English fluently, but family may lack impartiality and create more complications. Having a trained, qualified medical interpreter is the safest and most effective option for those who need interpretive services. At UofL Health, our interpreters are held to a high standard to uphold the best patient care.
Other risks to using a patient’s relative as an interpreter include lack of neutrality, potentially strained relationships or miscommunication of care. We will take a deeper look into each of these issues and what team members are risking when they use a visitor as an interpreter for a patient.
Miscommunication of care: It can be easy for instructions or advice from the provider to be misinterpreted back to the patient with a family member as the interpreter. Omissions and inaccuracies are common when using a family member as an interpreter and can be detrimental in the care of the patient which can lead to mistakes and much worse. A medical trained professional has the comprehension of medical and general health care terms and can not only interpret them but can further explain them in layman terms for cohesive understanding.
Lack of neutrality: Due to power dynamics or emotional ties with said loved one, it is best to have an unbiased or impartial interpreter that will be sure to communicate the trained medical advice. A trained interpreter can also communicate the patients’ concerns and needs without judgment as they are neutral participants who are solely focused on the best medical care without an emotional bias.
Potentially strained relationships: Some family members, especially children, may not be able to communicate critical personal information. Some communication needs may be too traumatic for family members to fully process at the moment while still bearing the stress of the job as the interpreter. A trained professional can take the weight of stress off of family members, especially if the patient may be critically ill and want to control how the family is informed.
At UofL Health, we have our own designated Language Services department with over 20 staff interpreters and offer more than 200 languages over-the-phone and video remote, and more than 60 languages available for face-to-face interpretation, including American Sign Language (ASL). In UofL Hospital, Jewish Hospital and Mary & Elizabeth Hospital we have in-house interpreters available by pager, while in other locations professional interpreters may be arranged prior to the expected date of treatment or consultation to ensure the highest quality of care. When face-to-face interpreters are not available, the over-the-phone and/or video remote services are widely available in all facilities. The Language Services team is highly skilled and delivers accurate interpretations while ensuring transparency and the need to be informed for both patients and staff to reach common goals and objectives.